MEDICARE: MODERN MENTAL HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	103TP2701X	Group Psychotherapy Psychologist

General Provider Information

NPI Number	:	1487271763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODERN MENTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	1221 34TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1842
Country	:	US
Telephone Number	:	848-299-9329
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 GULF TO BAY BLVD STE 312
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-4304
Country	:	US
Telephone Number	:	727-279-0101
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACLYN MATTHEWS
Credential	:	LMHC
Telephone Number	:	848-299-9329

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	07/02/2020

Similar Medicare Providers

1093065807 — DR. STEFANIE J COPPES PH.D.
Practice Location Address:

3000 GULF TO BAY BLVD STE 300
CLEARWATER, FL
33759-4304

Practice Phone: 800-687-1938
Practice Fax: 727-495-7233

1982089140 — SAMANTHA C OMELIAN PH.D.
Practice Location Address:

3000 GULF TO BAY BLVD STE 300
CLEARWATER, FL
33759-4304

Practice Phone: 800-687-1938
Practice Fax:

1871956805 — COASTAL NEUROPSYCHOLOGY, LLC
Practice Location Address:

3000 GULF TO BAY BLVD STE 300
CLEARWATER, FL
33759-4304

Practice Phone: 800-687-1938
Practice Fax: 727-495-7233

1013467919 — JENNIFER THIBODEAUX PH.D.
Practice Location Address:

3000 GULF TO BAY BLVD STE 300
CLEARWATER, FL
33759-4304

Practice Phone: 727-222-5821
Practice Fax:

1184160590 — JACLYN MATTHEWS LMHC
Practice Location Address:

3000 GULF TO BAY BLVD STE 312
CLEARWATER, FL
33759-4304

Practice Phone: 727-279-0101
Practice Fax:

1912473075 — CONCIERGE CARE OF CLEARWATER, LLC
Practice Location Address:

2963 GULF TO BAY BLVD , STE 323
CLEARWATER, FL
33759-4304

Practice Phone: 813-249-2273
Practice Fax:

Directions to “MODERN MENTAL HEALTH LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.